PT  - JOURNAL ARTICLE
AU  - Ziyi Wang
AU  - Elianna A. Bier
AU  - Aparna Swaminathan
AU  - Kishan Parikh
AU  - John Nouls
AU  - Mu He
AU  - Joseph G. Mammarappallil
AU  - Sheng Luo
AU  - Bastiaan Driehuys
AU  - Sudarshan Rajagopal
TI  - Diverse cardiopulmonary diseases are associated with distinct xenon magnetic resonance imaging signatures
AID  - 10.1183/13993003.00831-2019
DP  - 2019 Dec 01
TA  - European Respiratory Journal
PG  - 1900831
VI  - 54
IP  - 6
4099  - http://erj.ersjournals.com/content/54/6/1900831.short
4100  - http://erj.ersjournals.com/content/54/6/1900831.full
SO  - Eur Respir J2019 Dec 01; 54
AB  - Background As an increasing number of patients exhibit concomitant cardiac and pulmonary disease, limitations of standard diagnostic criteria are more frequently encountered. Here, we apply noninvasive 129Xe magnetic resonance imaging (MRI) and spectroscopy to identify patterns of regional gas transfer impairment and haemodynamics that are uniquely associated with chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), left heart failure (LHF) and pulmonary arterial hypertension (PAH).Methods Healthy volunteers (n=23) and patients with COPD (n=8), IPF (n=12), LHF (n=6) and PAH (n=10) underwent 129Xe gas transfer imaging and dynamic spectroscopy. For each patient, three-dimensional maps were generated to depict ventilation, barrier uptake (129Xe dissolved in interstitial tissue) and red blood cell (RBC) transfer (129Xe dissolved in RBCs). Dynamic 129Xe spectroscopy was used to quantify cardiogenic oscillations in the RBC signal amplitude and frequency shift.Results Compared with healthy volunteers, all patient groups exhibited decreased ventilation and RBC transfer (both p≤0.01). Patients with COPD demonstrated more ventilation and barrier defects compared with all other groups (both p≤0.02). In contrast, IPF patients demonstrated elevated barrier uptake compared with all other groups (p≤0.007), and increased RBC amplitude and shift oscillations compared with healthy volunteers (p=0.007 and p≤0.01, respectively). Patients with COPD and PAH both exhibited decreased RBC amplitude oscillations (p=0.02 and p=0.005, respectively) compared with healthy volunteers. LHF was distinguishable from PAH by enhanced RBC amplitude oscillations (p=0.01).Conclusion COPD, IPF, LHF and PAH each exhibit unique 129Xe MRI and dynamic spectroscopy signatures. These metrics may help with diagnostic challenges in cardiopulmonary disease and increase understanding of regional lung function and haemodynamics at the alveolar–capillary level.Different heart and lung diseases exhibit unique 129Xe MRI and spectroscopy signatures. These may help differentiate cardiopulmonary disease and increase our understanding of regional lung function and haemodynamics at the alveolar–capillary level. http://bit.ly/2lZCsQy